Mental Health Disorders and Dementia in Ecuadorian Older Adults: A Nationwide Cross-Sectional Study.

BACKGROUND: Older adults are vulnerable to mental health disorders, and hospitalization typically indicates severity. This study aimed to identify the most common mental health disorders leading to hospitalization among older adults in Ecuador. The frequency of different types of dementia, including Alzheimer's disease, vascular dementia, and other forms of dementia, as well as non-alcohol-induced delirium, was also analyzed. METHODS: Nine years of nationwide data were examined, including sociodemographic factors, types of disorders, and lengths of hospital stays for each mental health disorder based on ICD-10 criteria. The Ecuadorian National Institute of Statistics and Censuses provided the dataset for analysis based on hospitalization data. RESULTS: A logistic regression model was used to calculate adjusted odds ratios (aOR). Between 2015 and 2023, Ecuador recorded 10,949 hospitalizations for mental health disorders among the older adult population. The highest hospitalization rates observed were 10.17 per 100,000 inhabitants for mental and behavioral disorders due to psychoactive substance use, predominantly among males. Depressive disorder rates were 9.35 per 100,000 inhabitants, with higher odds in women (aOR 1.78, 95% CI 1.59-1.99). Adults aged 75-79 and 80+ had higher odds of hospitalization for Alzheimer's disease (aOR 7.64 and 10.81, respectively). Hospitalizations due to mental and behavioral disorders related to psychoactive substance use were typically shorter (less than 2 d), while schizophrenia spectrum and bipolar disorders were associated with longer stays (more than 11 d). CONCLUSIONS: Our findings reveal critical patterns of hospitalizations among older adults due to substance use and depression, providing data for public health policy and future research in similar settings.